Weekly risk of venous thromboembolism recurrence in patients receiving oral anticoagulants

Abstract

Background:

Data is currently lacking in evaluating the weekly rates of recurrent venous thromboembolism (VTE) among patients receiving anticoagulants.

Objective:

To quantify the risk of VTE recurrence during the first 12 weeks after an index VTE event.

Methods:

Healthcare claims from Truven Health Analytics MarketScan database from January 2007 to June 2012 were analyzed. Adult patients with ≥1 diagnosis of VTE, ≥1 anticoagulant prescription dispensed within 7 days of the index VTE hospitalization discharge or outpatient/emergency room (ER) visit (index date), and a proportion of days covered ≥0.7 on the anticoagulant therapy during the 12 weeks post-discharge were included. The weekly risk of VTE recurrence was evaluated with the hazard function using the life-table method.

Results:

A total of 105,682 patients with a VTE were included. Mean age was 59 years and 49% were female. The risk of VTE recurrence was at its highest during the first and second weeks, at 0.78% and 0.83%, respectively. The risk remained high during Weeks 3, 4, and 5 with risks of VTE recurrence of 0.63%, 0.52%, and 0.39%, respectively. The risk of VTE recurrence stabilized around Week 7, with risks of 0.26%, 0.22%, 0.20%, 0.25%, 0.23%, and 0.23% for Weeks 7, 8, 9, 10, 11 and 12, respectively.

Limitations:

Claims data may have contained inaccuracies. During hospitalizations it was not possible to assess anticoagulant use or a VTE recurrence occurring in the same hospitalization as the index VTE event.

Conclusion:

This analysis suggests that the risk of VTE recurrence remains high in the early weeks after an index VTE among patients receiving anticoagulants.

Keywords::

• Anticoagulants
• Recurrence
• Risk
• Venous thromboembolism

Transparency

Declaration of funding

This study was funded by Janssen Scientific Affairs LLC, Raritan, NJ, USA.

Declaration of financial/other relationships

F.L., M.C., and P.L. have disclosed that they are employees of Analysis Group Inc., a consulting company that has received research grants from Janssen Scientific Affairs LLC. B.B., C.V.D., and J.R.S. have disclosed that they are employees of Janssen Scientific Affairs LLC. C.I.C. and S.K. have disclosed that they received research grants from Janssen Scientific Affairs LLC.

CMRO peer reviewers on this manuscript have received an honorarium from CMRO for their review work, but have no other relevant financial or other relationships to disclose.